Travel Health Insurance in the Not-Quite, Maybe-Never, Post-Pandemic World

There’s never been a better time to revisit the issue of travel health insurance. What it should cover, what it probably covers, and if and how COVID has changed things.

By Deborah Sanborn | Outpost Travel Media | May 3/2022

Never ever go outside the borders of your home country without knowing if you’re covered if you get sick or injured abroad — by that I mean, without travel health or medical insurance! Never ever skimp on the cost or type of coverage or package you purchase — that is, only cover bare minimums. Never ever assume your credit card will automatically cover or protect you without condition or question, if you’re injured or sick abroad. 

Overall, in today’s not-quite, possibly-never, post-COVID-pandemic travel world, getting travel health insurance is an absolute priority if you’re venturing beyond your own backyard — even if you’re Canadian travelling outside of your home province. (Yes, that is true: despite the ideal of the Canada Health Act to ensure all Canadians have equal access to equal health and medical services, don’t count on not having to pay for some a particular province won’t cover (ambulance and evacuation services for certain circumstances come to mind). 

Not only could not having travel health insurance be a financial disaster, even worse, don’t count on not being denied treatment if you can’t pay. This is hard to imagine if you’re Canadian, with our preference for national public health care. But imagine you cross the US border for a shopping spree only to get in an accident that sees you in hospital for days, let alone with a serious injury…and you have no health insurance! (I grew up in a Canadian-US border town and it was a thing to drive across the bridge just to hit the local mall or dance floor. We never ever got insurance, and just thinking about it sends dollar signs up my spine.) 

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Yet adventure travellers should take note: that’s not only true for the United States — many hospitals abroad won’t treat non-nationals if you don’t have insurance, or can’t pay. Years ago, when first writing about travel health insurance, I interviewed Don Forster of Goway Travel who told me that in the early days of adventure travel “people just ran their companies until something happened.” (And then it did, he said, and went on to recount a story about how a truck on a tour in Africa had an accident that killed the driver and left one traveller a paraplegic.) 

• “Go Ready To Go“ at the Outpost Travel Health Center, revving up as travel gets back!

So, the first tip about travel health insurance is – just get it, no excuses. Most (and certainly reputable) tour operators and trip companies you book with require you to have it; and some countries will just not let you in without it, as well as proof you’ve purchased it, even if you’re travelling on a visa. 

The second tip is, know what to look for when shopping for a policy. Any insurer or travel company (and even the government of Canada) will tell you the basic provisions you need (and should always ask about) are coverage for emergency medical care, evacuation and repatriation services, and pre-existing conditions.

Here’s what that can mean:  

Medical services in your policy should include: Emergency care, hospital care (including in-patient, overnight and multi-day stays); out-of-hospital care, such as a local doctor’s or clinic service; necessary medications; and really, any treatment advised by a certified health care professional. 

Coverage for a pre-existing condition: Ensure you get coverage for any pre-existing condition, and be sure to disclose anything and everything about it! Disclosing one will definitely up the cost of a policy, but it’s absolutely advisable if you don’t want to end up in bankruptcy court. The Canadian government actually advises you get in writing that your condition is covered by the policy should you need health care abroad, or it affects your travel in any way.

Evacuation and repatriation services: Ensure your policy will cover evac services as well as transportation back to your home country, accompanied by medical care staff if deemed necessary. And to be clear, by that we mean, at no cost to yourself! 

Likely one of the most important things to assess when buying and comparing travel health insurance policies is what they will not cover — so, when reading over the policy, look specifically for the words “legal disclaimers,” or a box, question mark or asterisked number you can click on beside a bullet point that will take you to the fine print of restrictions. 

And, read this fine print! Look for (dis)qualifiers on pre-existing health conditions, circumstances (local, political, global or environmental events that can impact the assuredness of your coverage), and types of travel or activities you might engage in that might not be covered under a policy, or, that might nullify it outright. (Wingsuit gliding ain’t likely covered!) 

Here’s a few more guidelines when buying travel health insurance:

Ask the insurer if they have a 24/7 hotline or equivalent, and make sure you write down the contact info (and always have it on you). Ask if they will contact your family or loved ones for you when they’re notified about an issue, as you may be incapacitated and unable to do so yourself. 

Make sure you get more coverage than you might need, and be covered for more than seems necessary. Don Forster of Goway advised that a general guideline is to “make sure the dollar amount for health care is as much as the travel company requires,” and that “most companies ask for $1 million USD in coverage,” which is about “average.”

Ensure you fully understand what “pre-existing condition” means, and fully disclose it when purchasing. Do not lie, fudge, minimize or downplay a health or medical condition; doing so can void your policy, which means you’re on the hook for any costs associated with treating it abroad. Here’s a good guideline from the Government of Canada on what to ensure you’re insured for regarding pre-existing conditions. 

In fact, be honest and fully disclose everything: your age, health status, travel itinerary, anticipated length of trip, destinations (if multiple), type of adventures or activities you might engage in — especially the latter! If you know your trip or itinerary will include skiing or cave diving, disclose it, and specifically get coverage that includes it. If you decide spontaneously to strap on a parachute or bungee cord when you’re in your destination, call your insurance provider for permission or to up your coverage in advance, as that might be necessary.

 Beware the formal Government of Canada “Travel Advisory.” If the federal government of Canada has issued an “avoid non-essential” or “avoid all travel” advisory for a destination or country, this absolutely impacts travel health insurance! Insurers use these advisories as guidelines for coverage, and in fact might deny your claim if you’re injured or sick in a destination with one against it.

Of course, in our COVID-impacted travel world, this is especially important but also problematic: government travel advisories are notoriously cautious, meaning it doesn’t take much for one to be issued, which (as noted above) can render your insurance void. And the pandemic has dramatically shown, in real time and real terms, that the public health situation of any destination isn’t predictable — meaning there may be a ‘situational’ gap between when you buy the insurance and when you might need it in your destination. 

So: ask specifically about COVID-19 coverage! The government of Canada recommends you ask your insurance provider specifically about medical expenses related to COVID-19 when travelling, as well as if your policy covers trip cancellation and trip interruption should your destination be unexpectedly impacted by an outbreak.

I asked TD Insurance, which sells travel medical insurance plans, how COVID has impacted coverage, and this is what Kamana Tripathi, Associate Vice President, Travel Insurance (TD Insurance) had to say: “We recommend travellers understand their travel health insurance coverage as it relates to COVID-19 … In March 2022, the Canadian government removed the ‘avoid all non-essential travel’ and ‘avoid all travel’ advisories related to COVID-19. At TD Insurance, if these travel advisories are not in effect prior to your departure date, then COVID-19 related medical claims could be eligible for coverage under TD Travel Medical Insurance plans when travelling outside of Canada. If you are already at your destination and the Canadian government re-issues and ‘avoid all non-essential travel’ or ‘avoid all travel’ advisory, you are still eligible for COVID-19 related medical claims under your TD Travel Medical Insurance policy. It is important to note, like other insurance claims, that COVID-19 claims will be judged on a case-by-case basis based on the terms of your policy.”

Ask about a policy’s deductible and/or co-payment conditions and terms, which in some circumstances can be costly to a traveller. 

Ask if your policy has a “don’t delay calling clause.” Ask the insurer if they require you to contact them ASAP/prior to you seeking medical treatment. Some insurers can use this to nullify a claim, leaving you on the hook for the cost. 

What, if any, non-emergency medical and health services are covered? As just one example, you may need follow-up care for an injury or illness when abroad, and should know in advance if your policy covers these services.  

Be sure to get all medical, health, and hospital services receipts if you’ve received treatment while travelling; an insurer may require them. A doctor’s/hospital letter detailing the treatment (and how it was necessary) is also a good idea. 

Don’t rely on your credit card to automatically insure you when travelling. Again, I asked TD Insurance their stance on this, because their products include both credit cards and travel medical insurance, and here’s what Kamana Tripathi replied: “At TD Insurance, we recommend that you check if your credit card has travel insurance coverage before your departure date so you have time to top-up your coverage if necessary to bridge any coverage gaps before travelling. This will also allow you to purchase a travel medical insurance policy if your credit card does not have travel insurance coverage.” 

• The information provided in the Outpost Travel Health Center are guidelines only. Always (always!) get individual medical advice from your doctor, a travel health doctor, or at a travel health clinic before travelling. In fact, we always advise your first point of planning for any trip should be booking an appointment with your family doctor or at a travel health clinic (which specialize in destination health and safety info, and requirements). Be advised too, that some destination-specific vaccines or preventatives (such as for malaria or traveller’s diarrhea) may require multiple doses, and thus require days/weeks/months of spacing between. So, when it comes to travel and health, start your planning sooner than later.